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    Research progress of pharmacologic therapy in obstructive sleep apnea
    WU Xingdong, YUE Hongmei, ZHU Haobin, LIU Miaomiao, LI Yating, XU Jinhui
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (2): 215-229.   DOI: 10.12092/j.issn.1009-2501.2024.02.012
    Abstract353)      PDF (1349KB)(154)       Save
    Obstructive sleep apnea (OSA) is a common sleep disordered breathing disorder. As a major global public health problem, untreated OSA can lead to a variety of adverse health outcomes, including various cardiovascular and cerebrovascular diseases, metabolic disorders, and psychiatric disorders such as anxiety and depression. Traditional OSA therapies such as positive airway pressure (PAP), weight loss, oral?appliance, upper airway surgery, and postural therapy focus on the anatomical factors of OSA. However, the pathogenesis of OSA is heterogeneous, and non-anatomical factors also play an important role in most patients. Although there is no drug with exact efficacy for the treatment of OSA, with the deepening understanding of the pathophysiological mechanism of OSA, more and more clinical studies are devoted to the study of drug treatment of OSA and its complications, and a series of results have been achieved. The following is a review of the relevant studies on drug treatment of OSA in recent years, hoping to provide literature support and theoretical basis for future research on drug treatment of OSA.
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    Research progress in the treatment of early Alzheimer's disease with lecanemab
    JIN Panpan, LIU Yang, QIU Bo, WU Huizhen
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (2): 207-214.   DOI: 10.12092/j.issn.1009-2501.2024.02.011
    Abstract347)      PDF (672KB)(511)       Save
    Lecanemab is a new drug used to treat early Alzheimer's disease (AD) with mild cognitive impairment or mild dementia. It is a human anti-Aβ fibril monoclonal IgG1 antibody, which is injected intravenously into the patient, through the blood-brain barrier into the brain, clearing amyloid plaque, thereby slowing the rate of cognitive decline in patients and delaying disease progression. This article reviews the pharmacological studies, clinical studies, safety and limitations of lecanemab, in order to help clinical understand the current research status and existing achievements of this drug.
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    Progress in clinical research on remazolam
    XIN Yuqi, CAO Ya, WANG Yulong
    Chinese Journal of Clinical Pharmacology and Therapeutics    2023, 28 (10): 1195-1200.   DOI: 10.12092/j.issn.1009-2501.2023.10.014
    Abstract298)      PDF (624KB)(403)       Save
    Benzodiazepines are among the most commonly used drugs in the field of anesthesia. Remazolam is a newly developed ultra-short-acting benzodiazepine, which has the characteristics of rapid onset, rapid recovery, high safety, and less side effects such as hypotension and respiratory depression. The aim of this review is to summarize the progress of pharmacokinetics, clinical pharmacology mechanism of action and clinical application of remazolam.
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    Comparison of clinical effectiveness and safety between generic and branded dienogest tablets in the treatment of endometriosis
    LIU Qian, ZHANG Jianing, ZHANG Shuang, LIU Qinglan, ZHANG Baoyin, SUN Nan
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (5): 527-534.   DOI: 10.12092/j.issn.1009-2501.2024.05.007
    Abstract285)      PDF (1781KB)(57)       Save
    AIM: To evaluate the clinical effectiveness and safety of generic and branded dienogest in the treatment of endometriosis. so as to provide the basis for clinical use of dienogest. MEHTODS: The data of patients admitted to Third Affiliated Hospital of Zhengzhou University from August 2022 to August 2023 who received dienogest (2 mg/d, orally, for 6 months) for treatment of endometriosis were collected. The clinical efficacy and adverse reactions of generic drugs and original drugs in the treatment of endometriosis-related pain were compared through follow-up surveys of the two groups of patients at 3 months and 6 months respectively. RESULTS: There was highly significant reduction in pelvic pain in both groups with mean of similar in generic group (34.0±3.0) mm and branded group (34.5±3.9) mm. The most frequent drug-related adverse effects in generic dienogest was vaginal bleeding (93%) which was no statistical difference with branded dienogest (90%). CONCLUSION: The generic and branded dienogest have the same clinical effectiveness and similar safety.
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    Recent progress of targeting Nrf2-ferroptosis to treat brain injury after ischemic stroke
    LI Mei, LI Qiang
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (2): 188-197.   DOI: 10.12092/j.issn.1009-2501.2024.02.009
    Abstract280)      PDF (973KB)(166)       Save
    Emerging evidences suggest that ferroptosis plays a vital role in the pathophysiological process of brain injury after Ischemic stroke. Accumulating evidence supports  pharmacological inhibition of ferroptosis as a therapeutic target for brain injury after Ischemic stroke through activating nuclear factor erythroid 2-related factor 2 (Nrf2), which transcriptionally controls many key components of the ferroptosis pathway. In this review, briefly describe ferroptosis processes and the roles they play in contributing to brain injury after ischemic stroke in the brain. We then provide a critical overview of the relationship between Nrf2 signalling and ferroptosis. With a focus on discuss how therapeutic modulation of the Nrf2 pathway is a viable strategy to explore in the treatment of ferroptosis-driven brain injury after Ischemic stroke.
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    Research progress on drug treatment and drug resistance mechanism of gastrointestinal stromal tumors
    ZHAO Quanming, YANG Mandou, HU Yibo, SU Youtong, PU Li, ZHANG Yu, LI Wenliang
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (1): 82-89.   DOI: 10.12092/j.issn.1009-2501.2024.01.009
    Abstract255)      PDF (835KB)(440)       Save
    Gastrointestinal stromal tumors (GIST) are the most common mesenchymal-derived tumors of the gastrointestinal tract. Tyrosine kinase inhibitors (TKIs) are the cornerstone of GIST therapy, but mutations in resistance genes pose many problems for treatment, especially the heterogeneity of KIT resistance mutations. In recent years, with the release of a number of GIST related drug research and experimental results, the great potential of targeted therapy, immunotherapy and combination therapy to treat GIST in different directions has been revealed, providing more therapeutic directions for GIST. This article will review the experimental research and future direction in recent years.
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    Study on bioequivalence evaluation of dexamethasone acetate tablets in Chinese healthy volunteers
    XIAO Lei, XU Yuanyuan, HUANG Xiaoqing, ZHANG Wen, CAO Yang, XIE Jing, ZHOU Huan, HUANG Shunwang
    Chinese Journal of Clinical Pharmacology and Therapeutics    2023, 28 (12): 1365-1371.   DOI: 10.12092/j.issn.1009-2501.2023.12.006
    Abstract249)      PDF (1059KB)(117)       Save
    AIM: To assess the bioequivalence of oral dexamethasone acetate tablets between the test and reference formulations in healthy adult Chinese subjects on an empty stomach and after meals. METHODS: A randomized, open, single-dose, two-cycle double crossover bioequivalence study was followed. Twenty-four healthy subjects were included in the fasting group, and 32 healthy subjects were included in the postprandial group, taking 2 tablets (0.75 mg/tablet) of the test formulation (T) or 3 tablets (0.50 mg/tablet) of the reference formulation (R) per cycle for two cycles. The concentrations of dexamethasone acetate in human plasma were determined using liquid chromatography-mass spectrometry, and the pharmacokinetic parameters were calculated according to the non-atrial model using WinNonlin 8.0 software.The bioequivalence of both the test formulation and the reference formulation was evaluated. RESULTS: The pharmacokinetic parameters after oral administration of dexamethasone acetate tablets in a fasted state in subjects with the reference formulation are as follows: Tmax 1.13 (0.50, 4.00) and 1.00 (0.50,5.00) h, AUC0-t (72.25±21.55) and (69.23±17.76) ng·mL-1·h, Cmax (14.53±4.51) and (14.52±3.68) ng/mL, AUC0-∞ (74.63±23.01) and (71.32±19.12) ng·mL-1·h. The pharmacokinetic parameters after oral administration of dexamethasone acetate tablets in the postprandial state in subjects were as follows: Tmax 2.00 (1.00,4.50) and 1.50 (1.00, 4.50)h, AUC0-t (81.57±21.28) and (76.06±13.63) ng·mL-1·h, Cmax (12.14±3.21) and (11.93±2.78) ng/mL, and AUC0-∞ (85.12±23.92) and (78.95±14.99) ng·mL-1·h. The 90% confidence intervals for the geometric mean ratios of the main pharmacokinetic parameters of the test formulation of dexamethasone acetate to the reference formulation ranged from 80.00% to 125.00% under both fasting and postprandial conditions. CONCLUSION: Under fasting and postprandial conditions, the test formulation of dexamethasone acetate tablets was bioequivalent to the reference formulation of dexamethasone acetate tablets.
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    Pharmacological  and clinical evaluation of Dorzagliatin in the treatment of type 2 diabetes
    DU Xiaoyu, LI Yumeng, WU Huizhen, QIU Bo
    Chinese Journal of Clinical Pharmacology and Therapeutics    2023, 28 (10): 1177-1183.   DOI: 10.12092/j.issn.1009-2501.2023.10.012
    Abstract245)      PDF (639KB)(279)       Save
    Dorzagliatin is a new dual action allosteric systemic glucokinase agonist (GKA), which can simultaneously activate the glucokinase (GK) in the pancreas and liver, promote insulin secretion and liver glycogen conversion in patients with type 2 diabetes, and improve pancreatic islets β-Cell function and insulin resistance simultaneously stimulate intestinal GK to regulate the secretion of Glucagon-like peptide-1 to play multiple hypoglycemic effects. As the first marketed GKA drug, it provides a new therapeutic approach for patients with type 2 diabetes. This article reviews the mechanism of action, pharmacokinetics, Drug interaction, clinical research and safety of Dorzagliatin.
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    Mechanism of Pingxiao capsule promoting breast cancer apoptosis through AKT1/β-catenin signal based on network pharmacology
    CHEN Hongxiao, LIU Su, JIN Le, ZHANG Huihui, ZHANG Lei, CHEN Zhaolin
    Chinese Journal of Clinical Pharmacology and Therapeutics    2023, 28 (12): 1321-1330.   DOI: 10.12092/j.issn.1009-2501.2023.12.001
    Abstract227)      PDF (5786KB)(115)       Save
    AIM: To explore the potential mechanism of action of Pingxiao capsule in the treatment of breast cancer. METHODS: TCMSP, TCM-ID, GeneCards and other databases were used to screen the related targets of Pingxiao capsule and breast cancer. Cytoscape software builds drug-target-disease networks. R software was used for GO and KEGG analysis. Autodock Vina and Pymol software were used for molecular docking and visualization of Pingxiao capsule active ingredients and core targets. Core targets were analyzed by R software survival package, and genes closely related to overall survival time were screened out. Cell viability was detected by CCK-8 method. Flow cytometry was used to detect cell apoptosis. The protein expression levels of p-AKT1, β-catenin and cyclinD1 were detected by Western blot. RESULTS: A total of 194 drug targets were screened, 1612 disease targets were identified, 127 intersection targets were identified by Venn diagram, and 20 core targets were TB53, AKT1, TNF, CASP3, etc. GO analysis was mainly related to oxidative stress response, cell regulation of chemical reaction and other biological activities. KEGG analysis was mainly related to PI3K-AKT signaling pathway, TNF signaling pathway, IL-17 signaling pathway and other pathways. Molecular docking results showed that the active constituents were well combined with the core targets AKT1, MAPK1 and RELA. Cell experiments showed that quercetin (40, 80, 120 μmol/L) promoted apoptosis of breast cancer cells. Western blot analysis showed that the protein expressions of p-AKT1, β-catenin and cyclinD1 decreased with different concentrations of quercetin treated for 48h. CONCLUSION: Network pharmacology and cell experiments confirmed that Pingxiao capsule may exert its anti-breast cancer effect by regulating AKT1/β-catenin signaling pathway. 
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    Analysis of clinical characteristics of tramadol induced hypoglycemia
    LIU Wei, HE Qin, HE Yiran
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (7): 819-825.   DOI: 10.12092/j.issn.1009-2501.2024.07.012
    Abstract224)      PDF (556KB)(98)       Save
    AIM: To investigate the clinical characteristics of tramadol-induced hypoglycemia. METHODS: Case reports of tramadol-induced hypoglycemia were collected by searching Chinese and English data from the database establishment to April 28, 2023. RESULTS: Twenty patients were included, with a median age of 50 years (4, 88). Hypoglycemia occurred 1 h-23 d after tramadol administration, with a median blood glucose of 2.25 mmol/L  (0.22, 3.3) and a median daily dose of 300 mg (1.53, 14 000). The main clinical manifestations were unconscious (12 cases), multiple organ failure (7 cases), asystole and/or apnea (7 cases), seizures (4 cases), somnolence (3 cases) and sweating (3 cases).Tramadol concentrations were reported in 6 patients, with a median of 3.56 mg/L (0.47, 9.4). After stopping tramadol in 20 patients and giving symptomatic supportive treatment, 16 patients recovered, 1 patient had moderate brain dysfunction, and 3 patients died. CONCLUSION: Tramadol induced hypoglycemia can occur from 1 h to 23 d after administration, and can be clinically manifested as autonomic nervous system symptoms and neurohypoglycemia symptoms, mainly neurohypoglycemia symptoms. After stopping tramadol, most patients with hypoglycemia returned to normal, and severe patients can die.
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    Practice of model-informed drug development in pharmaceutical industry in China
    LI Jian, WANG Yuzhu, WANG Jun
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (5): 596-600.   DOI: 10.12092/j.issn.1009-2501.2024.05.016
    Abstract221)      PDF (932KB)(114)       Save
    Guideline of model-informed drug development was published by National Medical Products Administration in 2020, which provided technical guidance for the application of modeling and simulation in the process of new drug development. In July 2022, Center of Drug Evaluation conducted a questionnaire survey on the practical ability of pharmaceutical industry to apply model-informed drug development (MIDD) in the process of new drug development, in order to investigate the practice of MIDD in China. Based on the feedback data collected from enterprises, this paper analyzes the practice of MIDD in domestic pharmaceutical industry, and briefly discusses several problems that still exist at present.
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    Progress and prospect of inhaled biological agents in asthma
    LI Guanghui, HUANG Jing, ZHU Min, ZHAO Rui, WAN Yakun, CHEN Zhihong
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (4): 406-414.   DOI: 10.12092/j.issn.1009-2501.2024.04.007
    Abstract220)      PDF (904KB)(200)       Save
    More than 300 million people worldwide suffer from asthma, and the incidence is increasing year by year. As one of the most common chronic diseases, asthma is an immune-mediated inflammatory disease with complex triggering mechanisms and strong heterogeneity. With the in-depth study of physiological and pathological mechanisms, therapeutic small molecule and hormone drugs have been introduced to control and treat most patients, but about 5%-10% of patients still suffer from various subtypes of difficult to control and treat asthma, that is, severe asthma. In the past decade, with the rapid development of biopharmaceutical research, protein and antibody have become the key drugs for the treatment of severe asthma with high efficacy, high specificity and high safety. However, biological drugs are usually administered by injection, they cannot be noninvasive and directly delivered into the lung to quickly absorb and take effect. Therefore, there is an urgent need for the introduction of inhaled biologics with quick effectiveness, convenience, economy and safety in clinical. The review summarizes the existing small molecule, hormone and biological therapy drugs, and summarizes the development of inhalable biological agents of asthma, and analyzes the future prospects of the inhalable biological drugs, which is designed to deepen the perception of the direction of the inhalable biological drugs research, and update the information of the field, in order to provide reference for the development of more inhalable biologics.
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    Pharmacologic effects and clinical evaluation of Tenapanor, a new drug for hyperphosphatemia
    HOU Wenping, XU Lei, SU Changhai
    Chinese Journal of Clinical Pharmacology and Therapeutics    2023, 28 (12): 1429-1435.   DOI: 10.12092/j.issn.1009-2501.2023.12.014
    Abstract218)      PDF (700KB)(135)       Save
    Tenapanor is a novel phosphorus-lowering drug, which mainly inhibits sodium/hydrogen exchange protein 3 (NHE3), and also reduces intestinal phosphorus absorption by down-regulating the expression of sodium phosphate co-transporter protein (NAPI).Tenapanor is mainly used for the treatment of hyperphosphatemia in patients with end-stage renal disease-hemodialysis (ESRD-HD). Diarrhea is the most common adverse reaction to this product. This article reviews Tenapanor by performing a literature search on its pharmacological effects, pharmacokinetic properties, clinical evaluation, safety, drug interactions and dosage.
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    Application of population modeling analysis to evaluate the impact of gene polymorphism on drug PK/PD 
    LIU Lu, SHI Yufei, HE Qingfeng, XU Fengyan, WANG Kun, CAI Weimin, XIANG Xiaoqiang
    Chinese Journal of Clinical Pharmacology and Therapeutics    2023, 28 (11): 1275-1282.   DOI: 10.12092/j.issn.1009-2501.2023.11.010
    Abstract213)      PDF (705KB)(165)       Save
    Polymorphism refers to the simultaneous and frequent existence of two or more discontinuous variants or genotypes or alleles in a biological population, also known as genetic polymorphisms or genes Polymorphism. This gene polymorphism may have a certain degree of influence on the pharmacokinetics and pharmacodynamics of the drug. The study of genomics plays an important role in realizing personalized, patient-oriented precision medicine treatment. Population model analysis is to use a modeling method to quantitatively describe the correlation and variability between pharmacokinetic and pharmacodynamic parameters and individual characteristics and to quantify the impact of covariates. At present, this method has been widely used. This paper systematically introduces the application examples of using the population model approach to assess the effects of genetic polymorphisms on the drug PK/PD.
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    Effects of remimazolam on early postoperative cognitive function in elderly patients with hip fracture
    DUAN Gongchen, WU Jimin, XU Qiaomin, JIANG Jianxin, LAN Haiyan, ZHANG Xutong, YUAN Kaiming, LI Jun
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (2): 146-153.   DOI: 10.12092/j.issn.1009-2501.2024.02.004
    Abstract207)      PDF (749KB)(125)       Save
    AIM: To evaluate the effect of remimazolam on early postoperative cognitive function in elderly patients with hip fracture based on a randomized controlled trial. METHODS: A total of 106 elderly patients, aged 65-90 years, ASA grade Ⅱ or Ⅲ, who underwent hip fracture surgery under combined spinal-epidural anesthesia in the Sixth Affiliated Hospital of Wenzhou Medical University from December 2022 to June 2023 and met the inclusion criteria, were selected and randomized into remimazolam group (group R) and propofol group (group P) according to the random number table, with 53 cases in each group. Patients in group P received a slow intravenous injection of propofol at a dose of 0.3-0.5 mg/kg (injection time of 1min), followed by a pump infusion at 0.5-3 mg·kg-1·h-1 for maintenance. In group R, intraoperative sedation was maintained by remimazolam at 0.1-0.3 mg·kg-1·h-1 after a loading dose of 0.05 mg/kg (injection time of 1min). The pump infusion rate were adjusted by maintaining MOAA/S score at 3-4 and BIS value at 75-85, and stopped administering sedatives while suturing the incision. MOAA/S score, MAP, HR, RR, SpO2 and BIS values were recorded before sedation (T0), 5 (T1), 10 (T2), 15 (T3), 30 (T4) and 60 (T5) min after sedation and at the end of surgery. The emergence time, intraoperative amnesia, the incidence of postoperative delirium (POD) and delayed neurocognitive recovery (DNR) within 7 days after operation, and the occurrence of adverse events during perioperative observation were recorded. RESULTS: Compared with T0, the BIS and MOAA/S scores of the two groups at T1-T5 were significantly decreased, and the MAP and HR of the two groups at T1-T6 were significantly lower (P<0.05). Compared with group P, group R showed higher MAP at all time points from T1 to T6 (all P<0.05), shorter emergence time (6.6±1.8 vs. 7.7±2.2 min, P<0.05), less decline in Hopkins Verbal Learning Test scores on postoperative day 7 (3.9±3.9 vs. 6.2±4.6, P<0.05), lower incidence of postoperative delirium and DNR (7.5% vs. 28.3%,5.7% vs. 20.8%, P<0.05), higher incidence of intraoperative amnesia (52.8% vs. 28.3%, P<0.05) lower incidence of hypotension and bradycardia (15.1% vs. 37.7%, 5.6% vs. 22.6%, P<0.05), and fewer frequent use of vasoactive drugs (P<0.05). CONCLUSION: Application of remimazolam for perioperative sedation in elderly patients with hip fracture can provide effective sedation and stable hemodynamic, with little effect on early neurocognitive function, and overall safety higher than propofol.
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    Research progress in sodium calcium exchanger and heart failure with preserved ejection fraction
    CHEN Feng, HUANG Yuting, WANG Xiao, FAN Guanwei
    Chinese Journal of Clinical Pharmacology and Therapeutics    2023, 28 (12): 1403-1408.   DOI: 10.12092/j.issn.1009-2501.2023.12.010
    Abstract206)      PDF (721KB)(90)       Save
    Sodium calcium exchanger (NCX) is encoded by the SCL8 family genes and belongs to the cation/Ca2+ exchanger superfamily. It is a widely distributed cation transporter protein on membrane structures, controlling the outflow and inflow of cellular calcium, and playing a key role in maintaining stable intracellular calcium concentration and normal cardiac function; Heart failure with preserved ejection fraction is characterized by high morbidity, high hospitalization rate and high mortality, and there is no ideal treatment method at present. In HFpEF, overexpression of NCX reverse mode leads to impaired diastolic function of the heart, and calcium transient in myocardial cells varies depending on the etiology of HFpEF. At present, various specific inhibitors targeting NCX can specifically inhibit calcium influx, improve diastolic dysfunction of HFpEF, and improve the survival rate of HFpEF models. Actively developing compounds targeting NCX inhibition is an important scientific challenge.
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    Research progress of uterine endometrial epithelial cell organoids in the field of reproduction
    CAO Zhiwen, YAN Guijun
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (5): 576-582.   DOI: 10.12092/j.issn.1009-2501.2024.05.013
    Abstract203)      PDF (829KB)(295)       Save
    In recent years, significant progress has been made in the study of endometrial epithelial organoids in the field of reproduction. Traditional two-dimensional cell culture models and animal experiments fail to accurately replicate the three-dimensional structure and physiological functions of the endometrium, limiting the in-depth exploration of its normal physiological mechanisms and related disease mechanisms. Emerging organoid technologies have provided new avenues for research. These organoids, formed by self-organization of stem cells or progenitor cells in a three-dimensional culture system, faithfully recapitulate the characteristics of endometrial glands in situ. Not only can these organoid models mimic the changes in the endometrium at different stages of the menstrual cycle, but they can also simulate the interaction between the fertilized embryo and the endometrium. Moreover, organoid systems have become essential tools for fundamental research in the field of reproduction and for disease research, including studies related to reproductive biology, drug screening and development, disease mechanism exploration, drug action mechanisms, drug combination therapies, and targeted therapies. These studies have provided novel insights and methods for a deeper understanding of the biological properties of the endometrium, its disease mechanisms, and the development of therapeutic strategies for related disorders.
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    Mechanism of Yi-xin-yin oral liquid according to homotherapy for heteropathy theory based on UHPLC-Q-TOF/MS combined with network pharmacology and molecular docking techniques
    WANG Yejian, JIAO Guangyang, PANG Tao, WENG Nan, GAO Jie, LI Juan, CHEN Wansheng, CHEN Weidong, ZHANG Feng
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (1): 11-25.   DOI: 10.12092/j.issn.1009-2501.2024.01.002
    Abstract199)      PDF (4865KB)(81)       Save
    AIM: To predict the core targets and related signaling pathways of Yi-xin-yin oral liquid for the treatment of arrhythmia, heart failure and myocarditis based on UHPLC-Q-TOF/MS, network pharmacology, molecular docking methods, cell experiments, according to the “homotherapy for heteropathy” theory in traditional Chinese medicine. METHODS: UHPLC-Q-TOF/MS was used to analyze and identify the chemical composition of Yi-xin-yin oral liquid Extract and the blood-absorbing components of rats oral administrated with Yi-xin-yin oral liquid extract, which compounds were applied in the databases searching for the potential targets (TCMSP, SwissTargetPrediction) and disease targets (OMIM, Genecard). Venn diagram was used for target intersection, and the subsequent protein-protein interaction network obtained core targets by STRING11.5 database, and then construct a "disease-component-target" network by cytoscape3.9.0. Finally, DAVID database was used to analysis GO function and KEGG enrichment analysis of core targets, and molecular docking validation was performed using Autodock vina software.And, validated with H9c2 cells for potential active ingredients and targets. RESULTS: A total of 156 compounds were identified from Yi-xin-yin Oral Liquid extract; 34 compounds were identified from rat serum, including 6-gingerol, isoliquiritigenin, glycyrrhizic acid and other compounds, and 139 intersecting targets were obtained. The KEGG pathway enrichment analysis mainly involved the TNF signaling pathway, IL-17 signaling pathway, MAPK signaling pathway, PI3K-Akt signaling pathway and so on. The TNF and IL-6 targets were selected for molecular docking with the main compounds, and the docking results were good (less than -5 kcal/mol). In vitro cellular experiments have shown that Yi-xin-yin oral liquid can exert therapeutic effects by regulating TNF and IL-6. CONCLUSION: The main potential active ingredients of Yi-xin-yin oral liquid may be isoliquiritigenin, glycyrrhetinic acid, calycosin-7-glucoside, salvianolic acid B, and 6-gingerol, which mainly act on TNF, IL-6 and other targets to regulate specific signaling pathways and exert therapeutic effects.
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    Progress in perioperative application of tranexamic acid
    WANG Wenli, YAO Yiting, YANG Chun
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (2): 198-206.   DOI: 10.12092/j.issn.1009-2501.2024.02.010
    Abstract198)      PDF (649KB)(170)       Save
    Perioperative bleeding is closely related to the prognosis of patients, and massive blood loss can lead to serious adverse events. Tranexamic acid, a lysine derivative, exerts anti-fibrinolytic effects by competitively blocking lysine binding sites on plasminogen to achieve hemostasis. Perioperative use of tranexamic acid can effectively reduce the risk of bleeding and the need for blood transfusion, and reduce the risk of bleeding related complications and death. At present, the use of tranexamic acid for perioperative hemostasis is increasingly widespread, and it is gradually entering the consensus and guidelines in more surgical fields. In this paper, the mechanism of action, perioperative application and adverse reactions of tranexamic acid were reviewed, and the effectiveness and safety of tranexamic acid in different surgical types were discussed, so as to provide reference for the application and research of tranexamic acid in China.
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    Research progress of FLT3 inhibitors and drug resistance mechanisms in acute myeloid leukemia
    WU Tingkai, REN Chongchong, ZHANG Wanwan, LIU Bei
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (1): 90-98.   DOI: 10.12092/j.issn.1009-2501.2024.01.010
    Abstract192)      PDF (714KB)(178)       Save
    The FMS-like tyrosine kinase 3 (FLT3) gene mutation is the most common genetic mutation in acute myeloid leukemia (AML) and is associated with poor prognosis. Various targeted inhibitors have been developed for FLT3 mutations and have shown promising clinical efficacy. However, the emergence of resistance poses new challenges for targeted therapy in AML. This article provides an overview of the pathological and prognostic role of FLT3 mutations in AML, the current research progress on commonly used FLT3 inhibitors (type I and type II), the mechanisms of FLT3 inhibitor resistance, and strategies for overcoming resistance.
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    Research progress on the related treatment of progressive myoclonic epilepsy
    DANG Yangbin, LIANG Yuxin, WANG Tiancheng
    Chinese Journal of Clinical Pharmacology and Therapeutics    2023, 28 (10): 1184-1194.   DOI: 10.12092/j.issn.1009-2501.2023.10.013
    Abstract192)      PDF (738KB)(142)       Save
    Progressive myoclonic epilepsy (PME) is a rare epileptic syndrome closely associated with genetic factors. The disease is primarily inherited in an autosomal recessive manner, although there are rare cases that demonstrate autosomal dominant or mitochondrial inheritance. Common clinical features include myoclonus, multiple seizure types, and progressive decline in neurological and cognitive function. PME typically manifests in late childhood or adolescence but can occur at any age. It accounts for approximately 1% of epileptic syndromes among children and adolescents worldwide. In recent years, in addition to antiseizure medications, numerous non-pharmacological treatments have emerged, including dietary therapy, neuromodulatory therapy, immunomodulatory therapy, enzyme replacement therapy, gene therapy, etc. This article aims to review the research progress in the treatment of PME.
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    Involvement of intracellular organelle stress, autophagy and ferroptosis in cobalt chloride-induced vascular smooth muscle cell injury
    LEI Yan, PENG Xiaoyong, DENG Mengsheng, ZHANG Dongdong, ZHU Yingguo, WANG Jianmin, DUAN Zhaoxia, LI Tao, LIU Liangming, YANG Guangming
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (1): 1-10.   DOI: 10.12092/j.issn.1009-2501.2024.01.001
    Abstract189)      PDF (1695KB)(180)       Save
    AIM: To investigate the relationship between vascular smooth muscle cell (VSMC) injury, organelle stress response and autophagic cell death (autophagy) and ferroptosis induced by the chemical hypoxia inducer cobalt chloride (CoCl2) through the bioinformatics analysis and in vitro cell experimentation. METHODS: The dataset GSE119226 of VSMC treated with cobalt chloride was acquired from the gene expression database (GEO). The R language was used to investigate the relationship between CoCl2 treatment and organelle stress response (Golgi stress, endoplasmic reticulum stress) and two forms of cell death (ferroptosis and autophagic cell death). With primary cultured rat VSMC (rVSMC) and CoCl2-induced anoxia model, the changes in cell viability were detected by CCK-8 method, and reactive oxygen species (ROS) levels were measured using DCFH-DA method. The expression levels of HIF-1α (a key molecule in hypoxia), Golgi stress markers GM130 and p115, endoplasmic reticulum stress markers GRP78 and CHOP, autophagy markers LC3-II/LC3-I and Beclin1, and ferroptosis markers GPx4 and xCT were detected by Western blot. The effect of inducing or inhibiting organelle stress and cell death on the CoCl2-induced cell damage was also observed. RESULTS: Differentially expressed genes analysis of GSE119226 dataset showed that CoCl2 treatment of VSMCs had significant effects on organelle function and stress response, autophagy and ferroptosis-related genes, in which endoplasmic reticulum stress, protein processing in endoplasmic reticulum, regulation of Golgi to plasma membrane protein transport, autophagy/autophagic cell death, and ferroptosis pathways were remarkably enriched. The results of in vitro experiment showed that compared with normal rVSMC, cell viability was significantly decreased after CoCl2 treatment, as well as HIF-1α protein expression and ROS levels in rVSMCs were increased. In rVSMC treated with CoCl2, the expression levels of Golgi structural proteins GM130 and p115 (reflecting the occurrence of Golgi stress) were decreased, while the markers GRP78 and CHOP (reflecting the occurrence of endoplasmic reticulum stress) were increased. At the same time, CoCl2 treatment also reduced the expression of autophagy markers LC3-II/LC3-I and Beclin1 (indicating the decrease levels of autophagy), while the expression of ferroptosis markers GPx4 and xCT were decreased (indicating the occurrence of ferroptosis). Compared with CoCl2 treatment group, induced Golgi stress, endoplasmic reticulum stress, or ferroptosis could further reduce cell viability, while inhibition of these processes could improve cell viability. On the other hand, increasing the level of autophagy can improve the cell viability. CONCLUSION: Hypoxia induced by cobalt chloride can lead to VSMC injury. Golgi stress, endoplasmic reticulum stress, ferroptosis, and the reduction of autophagy level play an important role in it. Inhibition of organelle stress response and ferroptosis, or increase of autophagy level can improve VSMC injury caused by cobalt chloride.
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    Research advance in progesterone therapy for endometrial cancer
    ZHANG Liyi, GUO Zifen
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (2): 230-235.   DOI: 10.12092/j.issn.1009-2501.2024.02.013
    Abstract186)      PDF (631KB)(200)       Save
    Endometrial cancer originates from the endometrium and is one of the common gynecologic malignancies, with its incidence and mortality rate increasing year by year. Although endometrial cancer is more prevalent in the peri- and post-menopausal female population, it has been an evident trend in recent years towards younger patients. For young patients who have not yet given birth but intend to do so, the application of progestins in endometrial cancer treatment has made significant progress in clinical practice. Considering the existence of large individual differences and unclear mechanisms of action in the clinical application of progestins, this paper aims to provide an overview of the current clinical application status, efficacy, hormone resistance, and its mechanisms in the context of hormone therapy.
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    Targeted biotherapy for chronic obstructive pulmonary disease
    BAI Haodong, SHA Bingxian, Ambedkar Kumar Yadav, XU Xianghuai, YU Li
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (4): 377-382.   DOI: 10.12092/j.issn.1009-2501.2024.04.003
    Abstract185)      PDF (640KB)(79)       Save
    Chronic obstructive pulmonary disease (COPD) is the most common chronic airway disease. The current status of treatment based mainly on bronchodilators and ICS is not sufficient for all of COPD patients. Various studies have attempted to use biologics targeting specific cytokines and their receptors in COPD patients to alleviate respiratory symptoms or reduce the risk of acute exacerbations. However, they failed to bring significant clinical benefits. More studies are needed to further determine the efficacy of targeted biotherapy for COPD.
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    Inhibitory and clearance effect of azithromycin combined with levofloxacin on biofilm of different ST types of Klebsiella pneumoniae
    CAO Ruonan, LI Xiaoning, RUAN Xinran, LIU Shihui, CHEN Jingxuan, XU Hao, SHEN Jilu, ZHU Guoping
    Chinese Journal of Clinical Pharmacology and Therapeutics    2023, 28 (12): 1347-1356.   DOI: 10.12092/j.issn.1009-2501.2023.12.004
    Abstract185)      PDF (1800KB)(49)       Save
    AIM: Given the biofilm formation ability of different ST-type Klebsiella pneumoniae, our study was aimed at exploring the inhibitory and clearance of azithromycin combined with levofloxacin on the biofilm of Klebsiella pneumoniae of different ST-types and providing a new strategy for the prevention of biofilm formation in the treatment of post-infectious Klebsiella pneumoniae. METHODS: 9 strains of Klebsiella pneumoniae from all susceptibility groups, 19 strains of Klebsiella pneumoniae producing extended-spectrum β-lactamases (ESBLs), and 37 strains of Carbapenem-resistant Klebsiella pneumoniae (CRKP) were randomly collected from the samples of patients hospitalized in the First Affiliated Hospital of Wannan Medical College from August 2019 to November 2021. The isolates were identified using VITEK MS IVD KB V3.2 and VITEK 2-Compact 60. Multilocus sequence typing (MLST) was performed to analyze the homology of each strain; crystal violet staining was used for semi-quantitative detection of biofilm to compare the differences in biofilm formation ability between different ST-type Klebsiella pneumoniae. Different ST-type strains were selected, and the partial inhibitory concentration index (FICI) was calculated by micro broth dilution method to judge the combination effect and select the optimal combination concentration; crystalline violet staining method was used to investigate the inhibition and clearance effect of azithromycin combined with levofloxacin on the biofilm of different ST-type Klebsiella pneumoniae; laser scanning confocal fluorescence microscopy was used to observe the structural changes of the biofilm of Klebsiella pneumoniae before and after the effect of the antibacterial drugs. RESULTS: MLST typing results showed that the sensitive group of Klebsiella pneumoniae strains had 8 sequences such as ST86, ST727, etc., the ESBLs group strains belonged to 14 sequence types such as ST15, ST37, ST11, etc., of which ST15 accounted for 26.32% (5/19). The CRKP group strains belonged to 9 sequence types such as ST11, ST15, ST656, etc., of which ST11 accounted for 48.65% (18/37), ST15 accounted for 27.03% (10/37); ST15 (ESBLs), ST11 (CRKP), ST15 (CRKP) type Klebsiella pneumoniae biofilms all reached maturity on the 5th day, the ST15 (ESBLs) group had a stronger ability to produce material to be membranous than the ST15 (CRKP) group. The ST11 (CRKP) group had a stronger ability to produce material to be membranous than the ST15 (CRKP) group (P<0.01); the results of azithromycin combined with levofloxacin drug sensitivity showed that it had an additive effect on different ST-type Klebsiella pneumoniae bacteria; in the inhibition of biofilm formation and clearance test, the 2×MIC azithromycin group and the combined concentration group had a stronger inhibition of biofilm formation of different ST-type Klebsiella pneumoniae bacteria, and the inhibitory ability of the combined group was better than that of the single-drug group, and the highest inhibition rate could reach 89.93%; the clearance effects were all combined drug group>azithromycin>levofloxacin, and the highest clearance rate was 44.79%. CONCLUSION: There are differences in biofilm formation ability between different ST-type Klebsiella pneumoniae, and azithromycin combined with levofloxacin has a better inhibitory effect on different ST-type Klebsiella pneumoniae biofilm, conbined application can be used in the treatment of biofilm infections early stage. 
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    Progress in researches for perampanel in the treatment of comorbidities of epilepsy
    CHEN Sirui, LI Junqiang, DANG Xiaoli, WANG Tiancheng
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (3): 354-360.   DOI: 10.12092/j.issn.1009-2501.2024.03.015
    Abstract183)      PDF (575KB)(126)       Save
    Sleep disorder, migraine, cognitive and behavioral disorders, anxiety and depression are common comorbidities of epilepsy. The comorbidity rate of epilepsy patients is eight times that of the general population, which affects the prognosis and quality of life of epilepsy patients. Perampanel (PER), as a third-generation antiseizure medication, has shown promising clinical research and application in the treatment of comorbidities in epilepsy. PER can improve the total sleep time, sleep latency and sleep efficiency of patients with epilepsy comorbid sleep disorder. PER also shows good efficacy in reducing seizure and migraine attacks of patients with epilepsy comorbid migraine. Meanwhile, the impact of PER on overall cognitive characteristics is neutral, with no systematic cognitive deterioration or improvement, but behavioral changes are one of the most common adverse events related to PER. For patients with comorbid anxiety and depression, PER does not exacerbate the anxiety and depression of epilepsy patients, and the severity of anxiety and depression in some patients will improve. This article will review the mechanism of action and clinical treatment research progress of PER on comorbidities of epilepsy.
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    Effects of remimazolam tosilate combined with remifentanil anesthesia on hemodynamics, serum IL-1β, CXCL8 levels in elderly patients undergoing spinal surgery
    DONG Li, ZHOU Feng
    Chinese Journal of Clinical Pharmacology and Therapeutics    2023, 28 (12): 1372-1377.   DOI: 10.12092/j.issn.1009-2501.2023.12.007
    Abstract180)      PDF (792KB)(57)       Save
    AIM: To investigate the anesthetic effect of remimazolam tosilate combined with remifentanil in elderly patients undergoing spinal surgery, and its impacts on hemodynamics, serum interleukin-1β (IL-1β) and C-X-C motif chemokine ligand 8 (CXCL8) level. METHODS: A total of 88 elderly patients who underwent spinal surgery in our hospital from May 2022 to May 2023 were randomly separated into an experimental group and a control group. The control group was given remifentanil, and the experimental group was anesthetized with remimazolam tosilate on the basis of the control group. The anesthesia effect, hemodynamic indicators, serum IL-1β and CXCL8 levels, and complication rate were compared between two groups. RESULTS: After different anesthesia regimens, the recovery time of spontaneous respiration, extubation time, and recovery time of the two groups were compared, and the experimental group were obviously shorter than the control group (P<0.05); compared with pre administration (T0), the fluctuation ranges of hemodynamic indexes, including heart rate (HR) and mean arterial pressure (MAP), in the experimental group after 1 min (T1), 5 min (T2) , 10 min (T3) and after extubation (T4) of administration were obviously lower than those in the control group (P<0.05). After surgery, the levels of IL-1β and CXCL8 in the serum of the two groups obviously increased (P<0.05), but the experimental group showed a obvious decrease compared to the control group (P<0.05); there was no significant difference in the incidence of complications between the two groups (P>0.05). CONCLUSION: The combined anesthesia of remimazolam tosilate and remifentanil has an ideal effect and high clinical application value for elderly patients undergoing spinal surgery.
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    Progress in the application of non-peptide gonadotropin-releasing hormone antagonist in the treatment of uterine fibroid
    ZHENG Yunxi, YI Xiaofang, XU Congjian
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (5): 482-487.   DOI: 10.12092/j.issn.1009-2501.2024.05.001
    Abstract179)      PDF (603KB)(136)       Save
    Non-peptide gonadotropin-releasing hormone antagonist (GnRH-antagonist) is a highly efficient and selective antagonist of GnRH receptor. The oral preparations (Elagolix, Relugolix and Linzagolix) had been approved for listing abroad. It shows efficacy in reducing the size of uterine fibroid and controlling heavy bleeding. Appropriate combination of‘add-back’therapy could improve the safety in medical application and patient compliance. Compared with other hormonal pharmaceuticals, oral GnRH-antagonists showed promising prospects in the treatment of uterine fibroid.
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    Stains: recent research progress for endometriosis
    QIN Xian, WANG Qian, HOU Jia, XU Dongmei
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (5): 488-494.   DOI: 10.12092/j.issn.1009-2501.2024.05.002
    Abstract175)      PDF (580KB)(95)       Save
    Defined as a common gynecologic endocrine disease, endometriosis is characterized by the presence of endometrium outside of the uterus cavity, affecting about 10% to 15% of reproductive-aged women worldwide.Moreover, Asian women tend to have a nine-fold increased risk of endometriosis compared with their white counterparts in Europe and the United States. Endometriosis not only causes chronic pelvic pain, dysmenorrhea, painful sex and other pain symptoms, but also leads to infertility, pushing the patients into a state of fatigue, high sensitivity and anxiety, thus reducing their quality of life. As the aging of Chinese population intensifies and the women's childbearing age delays, it is highly urgent to find solutions to those gynecological endocrine diseases such as endometriosis, which hamper women's fertility. In recent years, studies have shown that patients with endometriosis have abnormal serum lipid metabolism and an increased risk of cardiovascular diseases. At the same time, as a type of cholesterol-lowering drug, statins can inhibit the progression of endometriosis at the cellular and animal levels. Also, a few clinical studies have exhibited that statins exert a positive effect on the treatment of endometriosis. Therefore, this article aims to review the researches regarding the relationship between endometriosis and the cardiovascular disease, as well as the research progress of statin therapy on endometriosis based on the level of cells, animals and human beings. 
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    Molecular mechanism of high altitude hypoxia induced intestinal homeostasis imbalance and research progress of traditional Chinese medicine
    KANG Qian, XIU Minghui, ZHANG Xueyan, YANG Dan, WANG Shuwei, HE Jianzheng, GONG Hongxia, CAO Wangjie, SU Yun
    Chinese Journal of Clinical Pharmacology and Therapeutics    2023, 28 (12): 1391-1402.   DOI: 10.12092/j.issn.1009-2501.2023.12.009
    Abstract173)      PDF (1444KB)(106)       Save
    Hypoxia is one of the factors restricting the survival of people at high altitudes, which can cause various symptoms such as vomiting, diarrhea, palpitations, shortness of breath and acute coma. About 80% of patients with acute mountain sickness have at least one symptom of a gastrointestinal distress (e.g., anorexia, nausea, diarrhea, vomiting, etc.). The pathological characteristics, pathogenesis and drug treatment of intestinal injury caused by high-altitude hypoxia were studied, which is conducive to the diagnosis and treatment of plateau gastrointestinal diseases. Therefore, by summarized relevant literature and systematically expounds the related researches on intestinal damage caused by high altitude hypoxia. We summarized the changes of intestinal morphology, intestinal cells, intestinal flora and other intestinal homeostasis caused by high altitude hypoxia, the mechanism of intestinal inflammation and oxidative damage, and the treatment of traditional Chinese medicine, which provide reference and information for reference for scientific research workers and clinicians.
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    Di'ao Xinxuekang activates IRS-1/PI3K/Akt signal pathway to improve insulin resistance in nonalcoholic fatty hepatitis mice
    WANG Xin, WANG Yifan, SHANG Muhong, LIU Yuyan, CHEN Guangliang
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (2): 121-129.   DOI: 10.12092/j.issn.1009-2501.2024.02.001
    Abstract172)      PDF (2222KB)(100)       Save
    AIM: To study the effect and mechanism of Di'ao Xinxuekang (DXXK) on insulin resistance in nonalcoholic steatohepatitis (NASH) mice. METHODS: C57BL/6J mice were randomly divided into normal group and model group. After 16 weeks of high-fat diet, the model group was randomly divided into model group and Pioglitazone group (6.0 mg·kg-1·d-1), DXXK high, medium, and low (200, 60, 20 mg·kg-1·d-1) dose groups, with 8 animals in each group, and were administered by gavage for 8 consecutive weeks. The body weight, activity, fat mass, fasting blood sugar (FBG), serum insulin (FINS), total cholesterol (TC), triglyceride (TG), aspartic acid transaminase (AST), alanine amino transferase (ALT), and the contents of TC and TG in the liver were measured; oral glucose tolerance test (OGTT), intraperitoneal insulin tolerance test (IPITT), calculate insulin resistance index (HOMA-IR), insulin sensitivity index (ISI), area under curve (AUC) of OGTT and IPITT. HE staining was used to observe liver pathology, and Oil Red O staining was used to observe liver lipid accumulation. Western blot was used to detect the related proteins and downstream target SREBP-1c protein in the IRS-1/PI3K/Akt signaling pathway in liver tissue. RESULTS: Compared with the model group, the body weight, fat mass, FBG, FINS, HOMA-IR, ISI, TC, TG, AST, ALT levels, AUC of OGTT and IPITT in DXXK group and pioglitazone group were significantly reduced, significant increase in activity, liver lipid deposition and liver function abnormalities were significantly improved, hepatocyte steatosis and ballooning were significantly reduced, and liver p-IRS-1/IRS-1, PI3K, p-AKT/AKT protein expression was significantly increased, SREBP-1c protein expression was significant decrease. CONCLUTION: DXXK can improve insulin resistance in NASH mice, and its mechanism of action may be related to the activation of the IRS-1/PI3K/Akt signaling pathway.
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    Interaction effect and predictive efficacy of blood glucose and blood calcium on the prognosis of patients with acute severe pancreatitis
    HUANG Kaige, XU Qinhua, WANG Wei
    Chinese Journal of Clinical Pharmacology and Therapeutics    2023, 28 (11): 1227-1234.   DOI: 10.12092/j.issn.1009-2501.2023.11.004
    Abstract171)      PDF (1200KB)(57)       Save
    AIM: To investigate the interactive effects of blood glucose and blood calcium on the prognostic impact of patients with acute severe pancreatitis (SAP) and to analyze their predictive efficacy on prognosis. METHODS: One hundred and seven patients with SAP admitted to our hospital from September 2019 to October 2022 were selected for the study and were divided into poor and good groups according to their prognosis within 28 d. The blood glucose, blood calcium, modified Marshall score, bedside acute pancreatitis severity score  (BISAP) were compared between the two groups before treatment, after 3 d of treatment, and after 7 d of treatment, and the correlation between blood glucose, blood calcium and modified Marshall score and BISAP score was analyzed. The blood glucose levels of patients with different blood calcium were compared. Cox regression was used to analyze the factors associated with prognosis. The presence and type of interaction between blood glucose and blood calcium on prognosis were analyzed using the interaction coefficient γ and relative risk (RR) values. The subject operating characteristic curve (ROC) was used to analyze the predictive efficacy of blood glucose and blood calcium on prognosis. RESULTS: The blood glucose, modified Marshall score, and BISAP score of the adverse group after treatment were higher than those of the good group, while the blood calcium was lower than that of the good group (P<0.05). After 3 and 7 days of treatment, blood glucose was positively correlated with improved Marshall score and BISAP score (P<0.05). The blood glucose level in patients with decreased blood calcium was higher than that in patients with normal blood calcium (P<0.05). The decrease of blood calcium had positive interaction with the increase of blood glucose (P<0.05). After 3 and 7 days of treatment, the AUC of blood glucose combined with blood calcium was greater than that predicted by single index (P<0.05). CONCLUSION: Blood glucose and blood calcium are related to the severity of the disease in SAP patients. There is an interaction between blood glucose and blood calcium in predicting the prognosis of SAP patients. The combined detection of blood glucose and blood calcium has a certain predictive effect on the prognosis of SAP patients.
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    Central mechanism of curcumin on the paraventricular hypothalamic nucleus of high salt induced hypertension rats
    MENG Tingting, GAO Hongli, GAO Yifan, ZHANG Qinglan, YU Xiaojing
    Chinese Journal of Clinical Pharmacology and Therapeutics    2023, 28 (12): 1357-1364.   DOI: 10.12092/j.issn.1009-2501.2023.12.005
    Abstract169)      PDF (2189KB)(59)       Save
    AIM: To assess the effect of curcumin in hypothalamic paraventricular nucleus (PVN) and mean arterial pressure so as to explore the central mechanism of hypertension. METHODS: Sixty Sprague-Dawley rats which body weights between 170 and 190 grams fed with a normal salt (0.3% NaCl) or a high salt (8% NaCl) diet for 6 weeks. Meanwhile half of each team received curcumin administration or vehicle by intragastric administration. Mean Arterial pressure was measured noninvasively via tail-cuff instrument and their recording system. The PVN tissue samPles were collected and stored at ?80 °C for later analyses. We performed the following experimental procedures: Western blot analysis, immunofluorescence, immunofluorescence and statistical analysis. RESULTS:The average arterial blood Pressure of rats in the high-salt diet group was significantly reduced after 6 weeks of curcumin intervention. The levels of NOX2, NOX4, TLR4, MyD88, IL-6, IL-1β, MCP-1 and ROS in the long-term high-salt diet grouP were significantly higher after curcumin intervention. CONCLUSION:Curcumin can improve blood pressure in hypertensive rats induced by long-term high salt, the mechanism may be related to the imProvement of oxidative stress and inflammatory cytokines in the paraventricular nucleus of the hypothalamus.
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    Investigation and analysis of the current status of clinical research nurses
    CHEN Liming, ZHANG Haiyan, HUANG Fan, ZHAO Wenyan, DING Rui, CAO Cai, FANG Yi
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (4): 455-459.   DOI: 10.12092/j.issn.1009-2501.2024.04.014
    Abstract168)      PDF (509KB)(49)       Save
    AIM: To investigate and analyze the current situation and needs of clinical research nurses in China, in order to provide scientific basis for constructing a training system for research nurses, promoting standardized training, and achieving standardized management for them. METHODS: A self-made questionnaire was used to investigate 102 research nurses from nearly 70 well-known clinical trial institutions in China. The contents of the questionnaire mainly included the general information, professional experience and work content of the research nurses, the sense of accomplishment and training needs of clinical trial work. RESULTS: Among the 102 research nurses surveyed, 92.15% have a bachelor's degree or above; 53.92% of those have intermediate or higher professional titles; 74.51% of them are part-time research nurse. Among professional experiences, 19.61% have more than 10 years of clinical trial experience; 47.06%, 40.20%, and 21.17% of surveyed research nurses were authorized to participate in clinical trial drug management, sample management, and quality control; 70.59% of research nurses have a high sense of achievement in their daily work. In terms of education and training needs, clinical trial related laws and regulations, standardized training for clinical trial protocol implementation, and good clinical practice (GCP) are the three most important aspects. CONCLUSION: Clinical research nurses in China have a relatively high level of education and nursing experience, but there is still a large gap in the amount of professional full-time clinical research nurses in China. Due to the rapid development of innovative drugs and devices, as well as the urgent need to improve the clinical research system, it is necessary to establish a training, assessment, and evaluation system for research nurses that is in line with China's national conditions in order to improve the professional level of research nurses, and improve the quantity and quality of clinical trial research on innovative drugs and devices in China.
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    Mechanism and treatment of mucous hypersecretion in chronic obstructive pulmonary disease
    ZHANG Ting, SUN Rong, YANG Yong, LIU Weichun, YUAN Yuping, JU Xu, WANG Qian
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (4): 383-391.   DOI: 10.12092/j.issn.1009-2501.2024.04.004
    Abstract166)      PDF (719KB)(155)       Save
    Airway mucus hypersecretion is one of the important pathophysiological and clinical manifestations of chronic obstructive pulmonary disease. It has been reported in the literature that COPD patients with chronic airway mucus hypersecretion have more frequent acute exacerbations, more severe lung function decline, and higher hospitalizations and mortality. Therefore, it is particularly critical to understand the pathogenesis of hypersecretion of mucus in chronic obstructive pulmonary disease and find out effective treatment. This article focuses on the structure, significance of airway mucus and the mechanism of hypersecretion of mucus in chronic obstructive pulmonary disease (COPD). In addition, we also summarized drug and non-drug therapy for chronic airway mucus hypersecretion in this article. Drug therapy includes traditional drug therapy, some new targeted drug therapy for pathogenesis and traditional Chinese medicine therapy, and non-drug therapy includes smoking cessation, physical therapy and bronchoscopy therapy. We hope that it will provide new ideas and directions for the treatment of mucus hypersecretion in COPD patients.
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    Research progress on the treatment of Alzheimer's disease based on the target of mammalian target of rapamycin
    WANG Zhun, SUN Yuying, HUANG Hanchang
    Chinese Journal of Clinical Pharmacology and Therapeutics    2023, 28 (12): 1378-1390.   DOI: 10.12092/j.issn.1009-2501.2023.12.008
    Abstract166)      PDF (758KB)(86)       Save
    Mammalian target of rapamycin (mTOR) regulates cell survival, proliferation, and metabolism. Alzheimer's disease (AD) is a common neurodegenerative disease with a complex pathogenesis and is closely related to aging. Studies have found that the pathological development of AD is often accompanied by changes in mTOR activity, but the role of mTOR in the pathogenesis of AD is not clear. In this paper, the complex of mTOR and its signaling pathways are first introduced, focusing on the effects of mTOR signaling pathways on synaptic plasticity and memory function, autophagy, β-amyloid-β (Aβ), Tau protein and brain insulin resistance and other AD pathological features, secondly, the regulatory effects of mTOR signaling pathways in anti-aging and life prolongation are described, and finally the application of mTOR inhibitors in AD pathological research is introduced to provide new ideas for delaying and improving AD.
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    Effects and mechanism of Ginseng Yixin granules (QSYXG) for heart failure with preserved ejection fraction based on the network pharmacology and molecular docking strategy
    CHEN Yulin, JIANG Hugang, WANG Xinqiang, LIU Kai, LI Yingdong, AN Tao, ZHAO Xinke
    Chinese Journal of Clinical Pharmacology and Therapeutics    2023, 28 (10): 1081-1092.   DOI: 10.12092/j.issn.1009-2501.2023.10.001
    Abstract166)      PDF (6309KB)(79)       Save
    AIM: To study the mechanism of Ginseng Yixin granules (QSYXG) in treating ejection fraction preserved heart failure (HFpEF) based on network pharmacology. METHODS: Effective chemical composition information of QSYXG particles was collected through TCMSP database; DisGeNET, GeneCards, OMIM database for obtaining HFpEF related targets; Metascape GO and KEGG enrichment analysis of the intersection targets of HFpEF; STRING Construction and analysis of the database PPI network; Cytoscape3.7.2 Software construction network diagram; Docking of the major active components to the core target with the AutoDock Vina software molecules, the results were visualized and analyzed with pymol. RESULTS: A total of 66 components and corresponding targets were obtained, HFpEF corresponds to 1 931 targets, The intersection of 127 targets, the main active ingredients are quercetin, kaempferol, β-sitosterol, etc.; TNF, AKT1, IL-6, P53 and JUN as the core targets, Good docking of the key components with the core targets; Mainly involving the positive regulation of gene expression, signal transduction, negative regulation of apoptotic process, positive regulation of cell proliferation and senescence, hypoxia response, negative regulation of gene expression, inflammatory response and so on, PI3K-Akt, AGE-RAG, MAPK, TNF, IL-17, and HIF-1 are the main associated signaling pathways. CONCLUSION: QSYXG may treat HFpEF by activating targets of TNF, AKT1, IL-6, P53, JUN, and regulating apoptotic process, cell proliferation, hypoxia response, and inflammatory response.
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    Novel mechanisms driving renal tubulointerstitial fibrosis
    ZHANG Yanni, DUAN Yuxin, BAI Yi, YU Jinyao, SUN Jiayi, WANG Zejie, LI Ling, YE Qifa
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (3): 348-353.   DOI: 10.12092/j.issn.1009-2501.2024.03.014
    Abstract165)      PDF (1252KB)(53)       Save
    Renal fibrosis, especially tubulointerstitial fibrosis, is the most common pathway of all chronic kidney diseases progressing to end-stage renal diseases. Several adaptive reactions occur in renal tubular epithelial cells after chronic injury, such as changes in glycolipid metabolism, unfolded protein response, autophagy and senescence, epithelial-to-mesenchymal transition and G2/M cell cycle arrest. Maladaptive repair mechanisms can induce tubulointerstitial fibrosis. This article will discuss the molecular mechanism of these adaptive responses of renal tubular epithelial cells driving renal tubulointerstitial fibrosis, and provide a basis for exploring new drug targets for renal tubulointerstitial fibrosis.
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    Progress in the potential therapeutic mechanism of mesenchymal stem cell-derived exosomes for liver fibrosis
    ZHAO Tingting, LI Junfeng, ZHANG Liting
    Chinese Journal of Clinical Pharmacology and Therapeutics    2024, 29 (4): 475-480.   DOI: 10.12092/j.issn.1009-2501.2024.04.017
    Abstract163)      PDF (888KB)(79)       Save
    Liver fibrosis is pathological in most chronic liver diseases. Exosomes secreted by mesenchymal stem cells (MSCs) can regulate liver fibrosis through mechanisms such as inhibition of inflammatory response and proliferation of activated hepatic stellate cells, regulation of immune cells and metabolism. Therefore, MSC-derived exosomes can be used as a cell-free therapy for chronic liver disease, expanding new ideas for the treatment of chronic liver disease. Recent researches on MSC-derived exosomes in the treatment of liver fibrosis are reviewed in this article.
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    Paraventricular thalamic nucleus nerve pathways involved in general anesthesia wakefulness and sleep wakefulness
    GU Yunfei, CHEN Suheng, YU Kaihua, BAO Zhenxing, LI Yulan
    Chinese Journal of Clinical Pharmacology and Therapeutics    2023, 28 (12): 1436-1440.   DOI: 10.12092/j.issn.1009-2501.2023.12.015
    Abstract157)      PDF (557KB)(178)       Save
    The paraventricular thalamic nucleus (PVT) is a key nucleus involved in wakefulness. PVT plays an important role in normal sleep-wake regulation, but its role may vary during anesthesia depending on the stage of anesthesia. This article will review the role of PVT in sleep and anesthesia based on its wakefulness function neural pathways.
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